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Pathophysiology > GI: Small and Large Intestine > Flashcards

GI: Small and Large Intestine Flashcards

1
Q

True or false: the small intestine has goblet cells

A

true

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2
Q

Brunner’s glands are specific to which part of the small intestine?

A

duodenum

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3
Q

_________ ______ are specific to the ileum

A

Peyer’s patches

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4
Q

What is the big function of the large intestine?

A

water absorption

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5
Q

True or false: there are goblet cells in the large intestine

A

TRUE

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6
Q

What are the general layers of the GI tract?

A 
epithelium
lamina propria
muscularis mucosa
submucosa
muscularis propria (circular muscle --> myenteric plexus --> longitudinal)
serosa/adventitia
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7
Q

What is gastroschisis?

A

extrusion of abdominal contents thru abdonimal folds (NO peritoneum)

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8
Q

What is omphalocele?

A

persistence of herniation of abdominal contents into umbilical cord - sealed by peritoneum

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9
Q

Define intussusception

A

bowel telescopes into distal segment (usually at ileocecal junction)

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10
Q

What are symptoms of intussusception?

A

abdominal pain with current jelly stools (usually in kids)

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11
Q

What is the name of the condition when the bowel twists around the mesentery?

A

volvulus

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12
Q

What is the most common acquired GI emergency in premature or low birth weight babies?

A

necrotizing enterocolitis

in small and large intestines, terminal ileum and ascending colon

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13
Q

What is Meckel’s Diverticulum?

A

persistence of omphalomesenteric duct (disease of 2s)

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14
Q

What is Hirschprung Disease?

A

absence of ganglion cells (premature arrest of neural crest cells migrating from the cecum to rectum

MISSING ENTERIC NEURONS (do biopsy to look for these - need to get to muscularis propria)

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15
Q

What are some signs of malabsorption?

A

chronic diarrhea
steatorrhea
weigh loss
abdominal pain

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16
Q

Define steatorrhea

A

72 hour fecal fat (>7 grams/24 hours), voluminous, malodorous

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17
Q

What symptoms can malabsorption lead to?

A

anemia (not enough B12, folate)
bleeding (not enough vit. K)
osteopenia and tetany (not enough Ca, Mg, Vit. D)
peripheral neuropathy (not enough vit. A and vit. D)

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18
Q

What is the most common disaccharidase deficiency?

A

lactase deficiency (leads to osmotic diarrhea)

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19
Q

What makes a lactose tolerance test positive?

A

administration of lactase producing symtoms

glucose rises to

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20
Q

What is abetaliporproteinemia?

A

decreased synthesis of apolipoprotein B (decreased ability to generate chylomicrons, decreased secretion of cholesterol)

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21
Q

What is the main physiological problem in celiacs?

A

damage to small intestine when gluten is consumed

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22
Q

What are some symptoms of celiacs?

A

diarrhea, weight loss, abrominal pain

dermatitis herpeformis

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23
Q

What is a main giveaway symptom of celiacs that presents on the skin?

A

dermatitis herpetiformis (skin blistering due to Ig deposition)

24
Q

What does celiacs look like on endoscopy?

A

atrophic mucosa (atrophied folds)

25
Q

Which disease is associated with flattening of the villi?

A

celiacs

26
Q

What is a big finding on biospy/histology of celiacs?

A

increased number of intraepithelial T lymphocytes (CD8)

27
Q

What is another disease that looks similar to celiacs but can be treated with antibiotics

A

tropical sprue (unknown cause)

28
Q

What are signs of acute colitis?

A

neutrophils in epithelium and lamina propria

29
Q

What are some bacteria that can cause acute colitis?

A 
cholera
campylobacter
shigella
salmonella
typhid
yersinia
e coli
30
Q

What are 2 viral causes of acute colitis?

A

norovirus

rotavirus (mostly kids - severe diarrhea)

31
Q

What are 3 parasites/protozoa that cause GI problems?

A

nematodes (ascaris)
flatworms
protozoa (giardia, entamoeba histolytica)

32
Q

What GI condition commonly follows a course of broad spectrum antibiotics?

A

pseudomembranous colitis

33
Q

What does pseudomembranous colitis look like on histology?

A

mushroom shaped protrusion over the normal mucosa

34
Q

What is a common GI problem that occurs in middle aged females but looks normal on endoscopy?

A

collagenous colitis

35
Q

How does collagenous colitis present?

A

chronic watery diarrhea (3-20 non bloody stools per day)

36
Q

How do you diagnose collagenous colitis?

A

histology (trichrome stain - look for collagen and look for lymphocytes in epithelium)

37
Q

Which form of colitis has a strong association with autoimmune diseases?

A

lymphocytic colitis

38
Q

If both feature symptoms of chronic diarrhea and passage of non bloody stool, what is the difference between lymphocytic and collagenous colitis?

A

lymphocytic: males and females equally
collagenous: females more (stains on trichrome)

39
Q

What is Whipple’s Disease?

A

gram positive rod shaped actinomycete (tropheryma whippleli) engulfed by macs

leads to malabsorption, lymphadenopathy, arthritis

40
Q

What is the pathogenesis of Whipples?

A

foamy macs distend the villi so vessels and lymphatics become congested –> poor absorption and function of villi)

41
Q

What is a potential cause of IBD

A

reduced enteric infections leading to inadequate development of gut immune response

42
Q

What are some symptoms of Crohns?

A

intermittent attacks of mild diarrhea, fever, abdominal pain, recurrent attacks or flare ups of diarrhea (can present abruptly with RLQ pain)

NON BLOODY

43
Q

True or False: Crohn’s can occur at any point along the GI tract

A

true (but usually ileum or ileocecal valve)

segmented involvement which spares some areas

44
Q

What does crohn’s look like on gross?

A

ulcerated mucosa and fistula formation

45
Q

What does Crohn’s look like on histology?

A

transmural inflammation, cryptitis, crypt abscesses, ulceration, non-caseating granulomas

46
Q

What is ulcerative colitis?

A

relapsing attacks of mucoid diarrhea WITH pain (can have an explosive initial attack with serious bleeding)

47
Q

What are 2 complications of ulcerative colitis?

A
  • primary sclerosing cholangitis

- cancer

48
Q

How does the inflammation of UC differ from Crohn’s?

A

inflammation of mucosa that is continuous (diffuse - begins at rectum and progresses proximally)

49
Q

What does the early phase of UC look like?

A

neutrophils and crypt abscesses

50
Q

What does the later phase of UC look like?

A

mucosa ulcerates and pseudo polyps form

51
Q

What does the LATE phase of UC look like?

A

atrophy and possible dysplasia

52
Q

True or false: UC is transmural

A

FALSE (only in mucosa/submucosa)

53
Q

What are the main differences between UC and Crohn’s?

A

Crohn’s is transmural
UC is only mucosa/submucosa

Crohn’s is non bloody
UC is bloody

Crohn’s is any part of GI (skipped areas)
UC is diffuse

54
Q

What are some extraintestinal complications with Crohn’s?

A

migratory polyarthritis

kidney stones

55
Q

What are some extraintestinal complications with UC?

A

primary sclerosing cholangitis

Pathophysiology (26 decks)

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